HLA matching and the United Network for Organ Sharing Allocation System: impact of HLA matching on African-American recipients of cadaveric kidney transplants.

Abstract:

BACKGROUND:A recent proposal supports the elimination of allocation points for human leukocyte antigen (HLA) mismatches (MM) in cadaveric kidney transplantation. The intent is to increase access for some racial groups that might be disadvantaged by the representation of race-specific HLA in a largely white donor pool. We report our experience from two transplant centers that serve a large African American (AA) patient population. METHODS:All cadaveric transplants into AA recipients from 1994 to 2000 (n=162) were included in a retrospective review. RESULTS:Superior graft survival was observed in AA recipients of 0 MM transplants. When induction therapy was used, the graft survival at 3 years for the human leukocyte antigen (HLA)-BDR MM grades given allocation points (0,1,2 MM) was 82% versus only 49% for BDR MM grades not given points (3,4 MM: =0.0022). CONCLUSIONS:Our collective experience demonstrates that AA patients having HLA-BDR MM grades given allocation points had better graft survival. Removing points for HLA from the national allocation system may result in significantly poorer outcome in AA kidney recipients.

journal_name

Transplantation

journal_title

Transplantation

authors

Rebellato LM,Arnold AN,Bozik KM,Haisch CE

doi

10.1097/00007890-200212150-00024

subject

Has Abstract

pub_date

2002-12-15 00:00:00

pages

1634-6

issue

11

eissn

0041-1337

issn

1534-6080

journal_volume

74

pub_type

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